Need advice on the ultimate set up...

[Mtnman]

Ok, this week I'm going to my "in network" DME to get my first set up.
I'd really appreciate your advice on the best equipment to give me the best chance at a good result. Here are my stats: My insurance will pay 80% after a $500 deductible. I'm 47, mainly a side sleeper and am already used to sleeping with things in my nose. I've been using a produce called "Easy Breather" which is essentially two plastic rings that I plance in my nostrils to open up my nasal airway. I have a perscriptin from my Doc for a "titrated cpap" which I'm guessing is an auto titrated machine. As far as masks, the "nasal air" mask appeals to me so far becuase of its simple design. Since I'm ok with the $500 deductibe and my 20% copayment, I guess cost is not an issue. While I know there is no single set up that will be best for every persons needs, what is the best advice based on what I've told you here?

Thanks SO much for taking the time to share your thoughts!

Ben
aka: mtnman

[alpha1340]

If your insurance is working like you said and you have to pay $500 before and then they kick in 20%. I would suggest buying from our sponsor so you can get the machine you want without the dme hassle. You can get an M-series auto w/humidifier for like $694 and it has aflex. I would def check out your options on paying out of pocket vs dme. Plus if you order from cpap.com they have free shipping over $100

[Pad A Cheek]

Hello and welcome. It sounds like you are ready and willing to get the best treatment possible for your sleep apnea.
As far as the titrated CPAP that is a straight CPAP titrated to your prescribed pressure I think. Whatever the pressure that you were titrated at on your second sleep study is what that would be set to.

As far as the best set up, the mask is the key. If you can get a comfortable mask you will be well on your way to success. Everyone differs in which mask suits them best. Try on several at the DMEs office and preferably lie down with them and with the pressure on the machine set to your pressure. That is the best way to know how it will feel to you. Do not take a mask that they push on you. You are the ONLY one who knows how it feels to you.

Good luck and rest assured there are many very helpful people on this forum that will help you along the way, We have all been where you are now.
Take care,

Karen

[Mtnman]

Sorry I forgot to mention that I have not had a sleep study. I've only done the overnight pulse Ox test that showed I had 78 events over 6 1/2 hours. My worst hour was 18 events. My average O2 over the entire night was 88%. My two lowest O2 reading were 70% and 71% for 9 and 12 minutes respectively. I cound get a sleep study but based on reading in this forum, I'd like to try APAP first. If that works, I have my answer. If not, I guess I'm off to a sleep study.

Also, I only have to pay for 20% of my machine after deductibel. My insurance will pay 80%. Thanks!

[Hambone]

Alpha's right, in my situation (sounds like similar insurance) it was cheaper to order from CPAP.com and pay the whole bill out of pocket than it would be going the DME route.

The reason is the DME will inflate the cost of a machine, mask, and humifier (if any) probably double the Cpap.com price....

BE CAREFUL though as CPAP.COM is an out of network provider in my case which takes the re-imbursement cost to 70-30 after a $1000.00 deductible!

"Bill my insurance" version of this site is a "In-network" provider for my insurance, so check into it thoroughly so your not taken.


Your smart to do research right now and ask questions that way you'll be informed when it comes time to make the purchase.

best of luck,

[Slinky]

Check w/your insurance to find which local DME suppliers they are contracted with. Shop each one of your local DME supplier options to see what machine and collateral equipment they offer you (humidifier, mask, etc.). Have them price it all out. Deduct your $500 deductible, then figure your 20% of the balance. Be sure to ask them what their mask exchange policy is.

Contact billmyinsurance.com to see if they work w/your insurance company. If they do get a quote on the exact equipment thru them and your costs.

Then price everything exactly out at cpap.com. Do the math and see which way you come out ahead.

It might well be worth your while to get your CPAP and humidifier from cpap.com but get your first few masks thru your local DME supplier if they offer a decent mask exchange policy.

[Guest]

Sorry I forgot to mention that I have not had a sleep study. I've only done the overnight pulse Ox test that showed I had 78 events over 6 1/2 hours. My worst hour was 18 events. My average O2 over the entire night was 88%. My two lowest O2 reading were 70% and 71% for 9 and 12 minutes respectively. I cound get a sleep study but based on reading in this forum, I'd like to try APAP first. If that works, I have my answer. If not, I guess I'm off to a sleep study.

Also, I only have to pay for 20% of my machine after deductibel. My insurance will pay 80%. Thanks!

It's great to study about all of the machines ahead of time, but you may be getting the "cart before the horse" if you find out that you need a Bi-PAP machine. Better do some studying and comparing on those, too. And, they're expensive.

Den